Alexithymia affects understanding of emotional expressions.

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Anomiel
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24 Jun 2013, 10:24 am

I found some interesting information, here is a short summary:
Research shows that it isn't (always) autism that causes autistics to have problems with the processing of emotional facial expressions as believed, it is co-occuring alexithymia.

http://en.wikipedia.org/wiki/Alexithymia wrote:
Alexithymia /ˌeɪlɛksəˈθaɪmiə/ is a personality construct characterized by the sub-clinical inability to identify and describe emotions in the self. The core characteristics of alexithymia are marked dysfunction in emotional awareness, social attachment, and interpersonal relating. Furthermore, individuals suffering from alexithymia also have difficulty in distinguishing and appreciating the emotions of others, which is thought to lead to unempathic and ineffective emotional responding.

In tests the subgroup of autistics that also have alexithymia had bigger problems with the processing of face expressions than those without. There was no correlation between facial expression processing and the "severity of autism", only with degree of alexithymia. The hypothesis is that the way alexithymics process (or don't process) emotions interferes with their ability to understand other peoples emotions. Some researchers want to change that aspect of the ASD diagnosis to reflect the findings. :?: It is believed that 50% of autistics have alexithymia as opposed to 10% of the neurotypical population.

Here is a 5-in-1 test. It includes an alexithymia test based on the official Toronto alexithymia scale:
https://qtrial.qualtrics.com/SE/?SID=SV_bxrdWqB1SXtMbJj
First posted in this thread http://www.wrongplanet.net/postt233652.html (post your results there)

Here is another alexithymia test http://oaq.blogspot.se/
First posted in this thread http://www.wrongplanet.net/postt78600.html


http://medicine.yale.edu/lab/mcpartland/publications/540_153753_Desai_Alexithymia_2013_FINAL.pdf wrote:

• Alexithymia is a trait characterized by difficulties in recognizing and describing emotions.

• Alexithymia is present in ASD
(50%)
and typical development
(10%).

• Behavioral studies suggest that alexithymia accounts for anomalous face processing in ASD.


http://pss.sagepub.com/content/24/5/723 wrote:
Alexithymia, Not Autism, Predicts Poor Recognition of Emotional Facial Expressions

In the present study, we sought to determine whether co-occurring alexithymia (characterized by difficulties interpreting emotional states) may be responsible for face-perception deficits previously attributed to autism. Two experiments were conducted using psychophysical procedures to determine the relative contributions of alexithymia and autism to identity and expression recognition. Experiment 1 showed that alexithymia correlates strongly with the precision of expression attributions, whereas autism severity was unrelated to expression-recognition ability. Experiment 2 confirmed that alexithymia is not associated with impaired ability to detect expression variation; instead, results suggested that alexithymia is associated with difficulties interpreting intact sensory descriptions. Neither alexithymia nor autism was associated with biased or imprecise identity attributions. These findings accord with the hypothesis that the emotional symptoms of autism are in fact due to co-occurring alexithymia and that existing diagnostic criteria may need to be revised.


http://medicine.yale.edu/lab/mcpartland/publications/540_153753_Desai_Alexithymia_2013_FINAL.pdf wrote:
Study results emphasize the importance of alexithymia in explaining phenotypic heterogeneity in ASD.
While basic problems in social perception may be universal to ASD, specific difficulties with emotion perception may be evident in a specific subgroup of individuals with ASD and alexithymia. Future research investigating emotional perception in ASD should account for level of alexithymic traits.


Any thoughts on this? Do you think the percentage of alexithymics is correct?



Last edited by Anomiel on 25 Jun 2013, 5:08 am, edited 7 times in total.

AgentPalpatine
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24 Jun 2013, 10:28 am

Would it be possible to provide examples? I for one wouldn't know what some of these terms mean if I hadn't read some posts on the matter in the last week.


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Anomiel
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24 Jun 2013, 10:42 am

AgentPalpatine wrote:
Would it be possible to provide examples? I for one wouldn't know what some of these terms mean if I hadn't read some posts on the matter in the last week.


Examples of what? There are short explanations of what alexithymia is in two places. There are no abbreviations that needs explaining.
I guess I can summarize it into something more readable, is that what you meant?

EDIT: I changed it now.



rdos
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24 Jun 2013, 11:30 am

To me it seems rather irrelevant. It still boils down to neurodiversity regardless if psychiatry describe it as Alexithymia or ASD. Since 50% of ASD also have Alexithymia, this new term is useless in itself since it is not a distinct condition, rather a different way to describe neurodiversity.



Anomiel
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24 Jun 2013, 11:41 am

rdos wrote:
To me it seems rather irrelevant. It still boils down to neurodiversity regardless if psychiatry describe it as Alexithymia or ASD. Since 50% of ASD also have Alexithymia, this new term is useless in itself since it is not a distinct condition, rather a different way to describe neurodiversity.


I do believe it is another name for neurodiversity too.
I find it fascinating with names for the different things that constitutes autism. Earlier they would had put it under the umbrella term "autism" without actually understanding what it is. It is the same with auditory processing disorder - it is often part of autism, but now they understand what it is a bit more. Though if they would remove those aspects from ASD (as if it was something separate) there wouldn't be a diagnosis left. But if they add all of this information instead, it might be useful. Moving in this direction might mean that everybody will know and care about the individual differences, rather than just assuming that it is exactly the same for everyone.

This specific research is also interesting as it proves that we just can't relate to NTs, and NTs can't relate to us.



rdos
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24 Jun 2013, 12:45 pm

I just read the wikipedia article, and I don't think the traits defined has been verfied to be closely related in any studies, meanng that Alexithymia is just another case of "we think those traits are related". I can say this because they include lack of imagination in their definition, just like SBC does in his AQ test, and I know for sure that lack of imagination is not an ASD trait, nor a neurodiversity trait.



Anomiel
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24 Jun 2013, 1:04 pm

^ I dislike the inclusion of "lack of imagination" too, and that is the most frequently disagreed with criteria that I've seen. Maybe it's the common mistake of assuming a more logical thinking style would mean deficits in imagination (which often is thought of as irrational), and that liking facts would indicate a "lack of imagination" when that is not what it is about? :?
They accuse aspies of the same. Which makes sense as the research shows alexithymia is the cause of many autism "symptoms".



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24 Jun 2013, 3:41 pm

I think they may be referring to spontaneous imagination. People with alexithymia tend to have a more controlled imagination but a low spontaneous imagination as per the two factor imagination scale.

Here is a link to that test. http://tfis.blogspot.com/

A low spontaneous imagination is common in autism and alexithymia but people with a more controlled imagination can be very creative also.



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24 Jun 2013, 8:09 pm

I took the test. I already knew I'm highly alexithymic but I have an excellent imagination and am also mostly unaware of how my body feels as well. This seems to be a rare mix.


Your total score on the Autism Quotient (out of 50):

32

Here is some information about the AQ from Wikipedia:

"The Autism Spectrum Quotient, or AQ, is a questionnaire published in 2001 by Simon Baron-Cohen and his colleagues at the Autism Research Centre in Cambridge, UK. Consisting of fifty questions, it aims to investigate whether adults of average intelligence have symptoms of autism or one of the other autism spectrum conditions.

In the initial trials of the test, the average score in the control group was 16.4, with men scoring slightly higher than women (about 17 versus about 15). 80% of adults diagnosed with autism spectrum disorders scored 32 or more, compared with only 2% of the control group.

The authors cited a score of 32 or more as indicating "clinically significant levels of autistic traits". However, although the test is popularly used for self-diagnosis of Asperger syndrome, the authors caution that it is not intended to be diagnostic, and advise that anyone who obtains a high score and is suffering some distress should seek professional medical advice before jumping to any conclusions.

A further research paper indicated that the questionnaire could be used for screening in clinical practice, with scores less than 26 indicating that a diagnosis of Asperger syndrome can effectively be ruled out.
It is also often used to assess milder variants of autistic-like traits in typically developing individuals to investigate the continuum hypothesis of autism spectrum condition."

Your total score on the Toronto Alexithymia Scale (out of 100):

86

The Toronto Alexithymia Scale is a measure of deficiency in understanding, processing, or describing emotions. It was developed in 1986 and later revised, removing some of the items.

Alexithymia is a personality construct characterized by the sub-clinical inability to identify and describe emotions in the self. The core characteristics of alexithymia are marked dysfunction in emotional awareness, social attachment, and interpersonal relating. Furthermore, individuals suffering from alexithymia also have difficulty in distinguishing and appreciating the emotions of others, which is thought to lead to un-empathic and ineffective emotional responding is prevalent in approximately 10% of the general population and is known to be comorbid with a number of psychiatric conditions. Alexithymia has been noted to overlap somewhat with the core features of autism, and is a personality trait found commonly in people on the autism spectrum.

The current version of the TAS has twenty statements rated on a five point Likert scale. The TAS uses cutoff scoring: equal to or less than 51 = non-alexithymia, equal to or greater than 61 = alexithymia. Scores of 52 to 60 = possible alexithymia.


Your total score on the Somatosensory amplification Scale (out of 40):

1

Somatosensory amplification (SA) is a tendency to perceive normal somatic and visceral sensations as being relatively intense, disturbing and noxious. It is a common feature of hypochondriasis and is commonly found with fibromyalgia, major depressive disorder, some anxiety disorders, Asperger syndrome, and alexithymia. One common clinical measure of SA is the Somatosensory Amplification Scale (SSAS).

It is unclear whether persons with SA have a truly increased physiological sensitivity to bodily sensations. One study paradoxically found lower levels of SA in hypochondriacs who reported being constantly aware of their own heartbeats. Tentative encephalography results, however, tend to indicate SA is more likely due to differences in long-latency cognitive processing, rather than objective physiological differences in sensitivity.
It is not currently known whether SA causes or is caused by any of these conditions, only that they are comorbid conditions. One small study did find that, in patients with depression, SA may be part of the depression (i.e., treating the depression reduced the SA


Your total score on the Glasgow Sensory Questionnaire (out of 168):

66

Sensory issues, such as the extreme dislike of certain tastes, textures and smells which can result in the restrictive diets often seen in autism, are soon due to be added to the official diagnostic criteria of the American Psychiatric Association (DSM-5). The GSQ was developed by autism researchers here at the University of Glasgow, it contains 42 items and investigates both hyper- and hypo-sensitivities in seven modalities: visual; auditory; gustatory; olfactory; tactile; vestibular and proprioceptive. Higher scores indicate the presence of both hyper and hypo-sensitivities across all modalities. Previous research has shown that a group of people with an AQ score of over 32 had an average GSQ score of around 90.



Your total score on the 'Multidimensional Assessment of Interoceptive Awareness' test. (out of 160):

46

A high score on this measure indicates that you are in tune with your body and its signals. More specifically, a higher score indicates that you have good bodily awareness across the following areas:

Noticing: Awareness of uncomfortable, comfortable, and neutral body sensations
Not-Distracting: Tendency not to ignore or distract oneself from sensations of pain or discomfort
Not-Worrying: Tendency not to worry or experience emotional distress with sensations of pain or discomfort
Attention Regulation: Ability to sustain and control attention to body sensations
Emotional Awareness: Awareness of the connection between body sensations and emotional states
Self-Regulation: Ability to regulate distress by attention to body sensations
Body Listening: Active listening to the body for insight
Trusting: Experience of one’s body as safe and trustworthy


One of the key aims of the study you just took part in was to see how patterns of responding to internal sensations relate to patterns of responding to external sensations (measured by the GSQ). Currently we know that responses to external stimuli become less normal as an individuals' level of autistic symptoms increases (measured by the AQ), but we don't yet know if responses to internal sensations follow this same pattern.



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24 Jun 2013, 8:33 pm

Marybird wrote:
I think they may be referring to spontaneous imagination. People with alexithymia tend to have a more controlled imagination but a low spontaneous imagination as per the two factor imagination scale.

Here is a link to that test. http://tfis.blogspot.com/

A low spontaneous imagination is common in autism and alexithymia but people with a more controlled imagination can be very creative also.


Intresting, I just took that test and scored 62/66 which is high spontaneous imagination although I also score very high on alexithymia. I have been realizing lately that my brain is not consistant with any psychological labels and defies psychological philosophy. To me it is like I do not have much control over what my brain does. It seems to work on its own. I do not understand emotion and am mostly unaware of my own feelings nor can I empathize or understand other people. At the same time I have an elabroite imagination. I would say I have a high level of derealization/depersonalization where I do not feel "in touch" but is if my thoughts and actions are controlled from somewhere else such as extra dimentional aliens. My emotional comprehension seems practally absent. I feel like an avatar of sorts but I also am very aware of what I am if that makes any sense. My body is just a vechile that I have obtained.



Anomiel
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25 Jun 2013, 4:29 am

Marybird wrote:
I think they may be referring to spontaneous imagination. People with alexithymia tend to have a more controlled imagination but a low spontaneous imagination as per the two factor imagination scale.

Here is a link to that test. http://tfis.blogspot.com/

A low spontaneous imagination is common in autism and alexithymia but people with a more controlled imagination can be very creative also.


Thank you, this really clarifies it :!: :!: :!:
:D I scored low on that test, but I am creative.



Anomiel
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25 Jun 2013, 4:50 am

Schizpergers wrote:
Marybird wrote:
I think they may be referring to spontaneous imagination. People with alexithymia tend to have a more controlled imagination but a low spontaneous imagination as per the two factor imagination scale.

Here is a link to that test. http://tfis.blogspot.com/

A low spontaneous imagination is common in autism and alexithymia but people with a more controlled imagination can be very creative also.


Intresting, I just took that test and scored 62/66 which is high spontaneous imagination although I also score very high on alexithymia. I have been realizing lately that my brain is not consistant with any psychological labels and defies psychological philosophy. To me it is like I do not have much control over what my brain does. It seems to work on its own. I do not understand emotion and am mostly unaware of my own feelings nor can I empathize or understand other people. At the same time I have an elabroite imagination. I would say I have a high level of derealization/depersonalization where I do not feel "in touch" but is if my thoughts and actions are controlled from somewhere else such as extra dimentional aliens. My emotional comprehension seems practally absent. I feel like an avatar of sorts but I also am very aware of what I am if that makes any sense. My body is just a vechile that I have obtained.


I think that might be influenced by you being a "schizpergers", they said this:
http://tfis.blogspot.se wrote:
Although the TFIS rates spontaneous imagining with a higher score, this should not be assumed to indicate a value judgment of psychological health. Whilst psychological health is usually characterized by a high degree of spontaneous imagination (Winnicott, 1971), there are notable exceptions to this rule in which a florid imagination can portend psychological disorder such as may be found in delusional, or schizoid states for example. Conversely, whilst a high degree of controlled imagining may be correlated with psychological disorders involving intellectualization, there are exceptions where, for example, one's culture, profession or current life circumstances require a stronger emphasis on controlled imagining. Finally, the TFIS is provided for gaining informal assessment which may indicate the need for a more thoroughgoing clinical assessment, or to compliment existing alexithymia measures. A TFIS score does not represent a diagnosis.


Having low awareness of ones body is a common autism-thing too, and if you have an added schiz-something it is kind of natural that you would experience that as you do. There seems to be a research category for those that have something both on the schizophrenia spectrum and the autism spectrum called MCDD - which you don't necessarily fit - so researchers are aware that there are people that have that:

http://en.wikipedia.org/wiki/Multiple_complex_developmental_disorder wrote:
Multiple complex developmental disorder is a research category, proposed to involve several neurological and psychological symptoms where at least some symptoms are first noticed during early childhood and persist throughout life. It was originally suggested to be a subtype of autistic spectrum disorders (PDD) with co-morbid schizophrenia or another psychotic disorder, however there is some controversy that not everyone with MCDD meets criteria for both PDD and psychosis.



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25 Jun 2013, 5:27 am

I tend to score firmly in the "alexithymia" range on tests intended to test that, and I tend to score fairly low on facial expression reading tasks, and I am much worse at that than I thought I was. I suppose it makes sense that the two are correlated - if you can't understand your own emotions, it's not so easy to understand others' emotions.



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25 Jun 2013, 5:33 am

I score highly on the reading the mind in the eyes test but I still score for having alexithymia.


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25 Jun 2013, 10:34 am

The results of the study make sense to me. I'm pretty sure the way I read a facial expression or body language is to imagine how my body would feel physically while imitating the expression or body position, then the physical feeling has some innate emotional meaning to me. It's a strange thing because I don't actually use the body language / expression I'm imagining in real life, but I still know it has a meaning intuitively. If If I didn't understand the connection between the way the muscles in my face feel while making a certain expression and the emotion it triggers I wouldn't be able to interpret the expression without relying on experience and rote memory. Into my late teens I had a really poor understanding of the meaning of words used to describe nuanced emotions so I wouldn't have done well on the "reading eyes" test due to poor understanding of emotional vocabulary. I caught up on that stuff in my 20s though because I began reading a lot more.

In summary, it seems like there could be all kinds of reasons for scoring low on facial expression reading tests, anything from not understanding nuanced emotions in yourself, to having trouble imagining what a facial expression feels like, to not understanding the vocabulary.