No association between alexithymia and emotion recognition or theory of mind in a sample of adolescents enhanced for autistic traits.
Georgianna Moraitopoulou, Hannah Pickard, Emily Simonoff and 3 others
PMID 38240268WHAT IT FOUND
In adolescents, alexithymia did not explain why autistic traits relate to poor emotion recognition or theory of mind.
Autistic traits alone predicted these difficulties. One unpre-registered subgroup finding suggested alexithymia linked to lower theory of mind in non-autistic youth only, but this did not hold after adjusting for verbal IQ.
Key findings
01Alexithymia was not associated with emotion recognition or theory of mind performance when adjusting for autistic traits, age, and sex.
02Higher autistic traits remained significantly associated with lower theory of mind accuracy, even when alexithymia was included in the model.
03A non-significant trend in the autistic group and a significant negative association in the non-autistic group suggested diagnostic status might moderate the link between alexithymia and theory of mind, but these findings were not pre-registered and lost significance after adjusting for verbal IQ.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Alexithymia was measured via parent report, which may not capture internal emotional states accurately, especially in autistic children who may have difficulty communicating these experiences. The sample had high verbal IQ scores and high parental education levels, limiting generalisability to more diverse populations. The study is cross-sectional, so it cannot determine developmental trajectories or causality. Key findings regarding diagnostic moderation were not pre-registered and are therefore exploratory. The age range (10-16) may be too young to capture the full impact of alexithymia on social cognition, which some theories suggest emerges later in adolescence or adulthood.
Declared interests
A.P. receives royalties from the Social Communication Questionnaire (SCQ). Funding was provided by Wellcome Trust, King's College London, and the National Institute for Health Research (NIHR).
The easy way to misread this
Do not conclude that alexithymia is irrelevant to social communication. This study only examined adolescents using parent-reported measures. The results do not rule out a role for alexithymia in adults or when measured via self-report. Additionally, the finding that alexithymia was associated with lower theory of mind in non-autistic youth was exploratory, not pre-registered, and disappeared after adjusting for verbal IQ.