Alexithymia: From neurobiological basis to clinical implications

Alexithymia is a construct of personality characterized by impairment in cognitive, emotional and affective processing. It describes people with deficiencies in identifying, processing, or describing subjective feelings or emotions. Although alexithymia is not a psychological disorder per se and it is normally distributed in healthy population, it is associated with enhanced risk of psychological impairment and it is present in a broad spectrum of psychiatric and psychosomatic disorders, as chronic pain, somatoform disorders, addictive disorders, anxiety and depression. By using neuroimaging studies, variations associated with functional and structural differences in people with high alexithymic traits are described in most of brain areas related to emotional awareness, as anterior cingulate cortex, fusiform gyrus, amygdala, parahippocampal gyrus and insula. Further, in the presence of alexithymia alterations are evidenced in the somato-sensory and sensorimotor cortices as well as in cerebellar areas. The link between limbic and somato-sensory systems may represent the possible neuroanatomical correlate of alexithymia. In the present chapter, the neurobiological basis and clinical implications of alexithymia are examined to clarify how the altered cognitive and affective experience of emotion may result in a deficit in the emotional awareness.