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Opening

Word disorder removed as it is not one. Sifneos reference added.— Preceding unsigned comment added by Supernaut76 (talk • contribs)

I don't know much about this topic, but maybe someone could put in an explanation as to how this differs from Asperger's and/or autism. Thanks.Amber388 17:14, 13 September 2006 (UTC)

The way Alexithymia has been described to me (I'm a SSU Graduate with a BA in psych) is that people with the condition aren't aware of their vareying emotions. They have difficulties "feeling" their emototions, or understanding their feelings. Unlike autism where they can't express or put into words what they are feeling, people with this disorder don't realize what they are feeling. — Preceding unsigned comment added by 12.155.182.227 (talk • contribs)

I disagree. It is now recognised that there is overlap between alexithymia and autism spectrum disorders, as Fitzgerald & Bellgrove (2006) point out. Both populations have great difficulty understanding and expressing their emotions. Hill & Berthoz (2006) in response to Fitzgerald & Bellgrove (2006), stated "We agree with Fitzgerald & Bellgrove (2006) that here is some form of overlap between alexithymia and ASDs". In addition, Moriguchi et al. (2006) found impaired Theory of Mind skill in people with alexithymia, there is evidence for neuroanatomical evidence of a shred aetiology (see Fitzgerald & Bellgrove (2006) and Hill & Berthoz (2006) for further similarities). The branched description of the same condition appears to have occurred because some researchers looked at alexithymia from an interpersonal and emotional point of view, its due mother not hugging you enough etc. I have amended the page to reflect recent findings. Diamonddavej 19:31, 11 April 2007 (UTC)

Diamonddave, Based on the available research, I agree with your response to Amber388. One point I wish to bring to your attention is the doubt now cast on the idea that alexithymic individuals have mind-blindness. A new fMRI study largely debunks this proposition. Also, although it looks like CeilingCrash (self-proclaimed Aspie, see his entries below) may be trying to disprove the whole role of alexithymia in AS, he may nevertheless have a point that Aspies may not have lack-of-ToM. The fMRI study throws the whole lack-of-ToM-in-alexithymia (and in AS) into serious doubt. The findings suggest that alexithymia may be more responsible for the AS-behaviour we have been calling mind-blindness. Just thought you might want to take a look over this study and see if the main article needs adjusting accordingly. PS. you've done a great job constructing the article so far. Soulgany101 07:10, 3 August 2007 (UTC)

Issue is controversial wrt Asperger's

It is now debated whether ToM applies to Asperger's (personally I would go so far to say it has fallen out of favor amidst researchers.) I'm adding WP:RS's to light up this emerging controversy CeilingCrash 19:42, 24 July 2007 (UTC) (added by ceilingcrash) It seems it would be best to remove mention of Asperger's altogether, and let the article focus on its topic : Alexithymia.CeilingCrash 19:47, 24 July 2007 (UTC)

CeilingCrash, This page is not about ToM in AS. Its about alexithymia. Alex and ToM involve substantially different and somewhat independent neural networks. So firstly we must leave 'ToM in AS' out of the discussion (thats something to be debated on the AS pages). Secondly, does the research on alexithymia in ASD's specifically include Asperger's individuals? Yes it does. I've seen two studies now (one of which fMRI study I already gave you the URL for on the "AS and Interpersonal Relations page" discussion area) which included Asperger subjects in the research.

See this one, for example, which explores the relationships between ToM, alexithymia, empathy, brain mechanisms, and ASD's: http://209.85.129.104/search?q=cache:HmnuhQtXSusJ:web.mit.edu/autism/Bird%2520-%2520Alexithymia%2520in%2520ASD.pdf+alexithymia+empathy&hl=en&ct=clnk&cd=17 In this study we read: "All participants in the ASD group had previously received a diagnosis of autism or Asperger’s Syndrome from an independent clinician according to standard criteria (DSM-IV, APA 1994)" Soulgany101 05:10, 3 August 2007 (UTC)

It is also very relevant to point out that alexithymia is found in co-morbidity with other disorders, and as ASD's have the highest prevalence (85%) of alexithymia of any disorder (that I am aware of) then it belongs in the entry as an example. Soulgany101 05:52, 3 August 2007 (UTC)

Theory-of-Mind in Asperger Syndrome

CeilingCrash. Your recent entry definitely does not belong on a page about alexithymia. It belongs on pages about AS. So I deleted it.

Here's what you wrote: Other research reports just the contrary, that people with Asperger's do not lack 'Theory of Mind'- nor a tendency toward Alexithymia.

Whilst reference to ToM in AS does not belong here, if you do have a reference to there being "no tendency toward alexithymia " then that is relevant. If you do have such information then please quote the source and phrasing here for us to look at. I did a brief search for the reference you gave above and found absolutely nothing (online) in it mentioning alexithymia. Also, the study was done in 1992 a full fifteen years ago, and well before the study by E. Hill, S. Berthoz, & U. Frith which found 85% of ASD's are alexithymic ] and before the Geoffrey Bird (et al) 2006 study Obviously any credible, up-to-date offering is of interest. Soulgany101 05:26, 3 August 2007 (UTC)

Huh?

Soulgany, I cannot follow your remarks.

To recap, a previous version of this article mentioned Asperger's and also that 85% of ASD's are alexithymic. I countered that the 85% figure has been refuted by other research and suggested the Alex. article simply focus on Alex and omit the murky connection to ASD and Asperger's. Somebody else did just that and I'm happy. CeilingCrash 04:37, 6 August 2007 (UTC)

Your "POV" that the 85% figure has been "refuted" needs proof, CeilingCrash. Its that Simple. If you can't provide the proof then you are just offering a predictable POV. Its no use giving some fuzzy, unsupported study from 15 years ago as you have done above. That 1992 study does not even refer to the 85% figure, let alone "refute it". Modern (that is recent) fMRI studies need a bit more than CeilingCrash's POV, or some unverified comment from years ago to refute them. (Huh indeed ;-) Soulgany101 09:47, 6 August 2007 (UTC)

Relational Section not good

Soulgany, you are pushing POV here to support your pet interest : Autism/Alex impacts couple relationships. The sources you provide for this section are poor, misinterpreted or both. Not every use of the Alex. Scale implies alexithymia, as the article titles indicate. I'll be back later with specifics; but material shd be added when it improves the article in and of itself. mCeilingCrash 08:48, 6 August 2007 (UTC)

CeilingCrash. The sources are extremely good, and the studies are of extremely high quality and reliable. This is not POV, as citations are provided and checked for reliability. Also, each study cited is not joined with other studies in the same section to form OR. Each study reference stands on its own.

Also, the relational section you dislike doesn't even mention "autism" whatsoever. So you are imagining things that arent even mentioned. Soulgany101 09:45, 6 August 2007 (UTC)

PS. Please do come back with specifics, and please back your claims this time. I look forward to discussing it Soulgany101 10:35, 6 August 2007 (UTC)

Never mind that, you can't keep posting links to your own blogs! C'mon, you know better than that! --Zeraeph 11:21, 6 August 2007 (UTC)

Zeraeph. Go ahead and delete the blogs if you wish. But stop deleting the other two outside links to the Alexithymia FAQ and Alexithymia Info. These last two are written by a Sam Brown who has a PHD in cognitive-neuroscience and who technically knows the subject of alexithymia. Please discriminate so that your deleting does not look like vandalism. Soulgany101 12:17, 6 August 2007 (UTC)

Can you please show evidence that this guy has a relevant PHD? This link at the bottom of the page (which seems to be on some kind of freeserver/subdomain) worries me in terms of validity. Also, as they cross link each other, and are by the same person, there is no justification for posting both. Choose one and delete the other while we sort it out please. --Zeraeph 17:34, 6 August 2007 (UTC)

To be exact- Sam Brown has a PhD in the philosophy of affective neuroscience. He has an MA in Philosophy and an MPhil in Cognitive Science from the University of Dundee. You can check these details with him by email, or you can contact the University of Dundee to confirm if you wish, and can publish his whole resume' next to the link. He also is a manager of the Alexithymia Chatsite under the username of "Hal".

The server Sam uses have corrupted one of his links, which now lead to a server default-page of unrelated links. This fault will be removed or corrected in time. Also, the links between the two pages (Info & FAQ) are not functioning and so both links are needed for access. These FAQ pages are widely recognized as the best overall online intro to alexithymia, and according to Sam have also been endorsed "by the professional body of alexithymia experts". As I say, get in touch either with him or the University of Dundee to confirm. Soulgany101 22:47, 6 August 2007 (UTC)

Soulgany, no, the link was not corrupted, but was transcribed incorrectly by Zereaph.

I, too, have been tracking down all the credits for Sam Brown and note that he blogs on the specific subject of neuroscience. Kiwi 23:04, 6 August 2007 (UTC)

No, the link is at the bottom of one of the pages and is totally correct, anyway, if he isn't formally published and peer reviewed and is just blogging he is not in accord with WP:EL and can go altogether. --Zeraeph 05:57, 7 August 2007 (UTC)

Zeraeph. Please discuss properly here before removing links. The links were not blogs belonging to some blogger service. They are very high quality pages about alexithymia by a person with relevant qualifications. If you mean they were blogs in some technical sense then maybe all websites are blogs. But you have been made aware that the author is highly qualified, and you have been told where to check his qualifications if you have doubts.

Alternatively, if you persist, be there is absolutely nothing to stop me quoting all the relevant quotes from those FAQ and Info pages (which is most of it) and placing them here on the Misplaced Pages entry! Much of that material can be lifted and mentioned here with citations. I'll be happy to oblige. Soulgany101 06:41, 7 August 2007 (UTC)

EG. some material for consideration:

_____________________________________________________________________________________________

Dictionary definitions

A succinct and accurate definition can be found in the American Psychiatric Glossary. The entry was written by John C. Nemiah, one of the psychiatrists responsible for coining the term, who was acting as a consulting editor.

American Psychiatric Glossary, 7th edition, p.6.

Alexithymia A disturbance in affective and cognitive functioning that overlaps diagnostic entries but is common in psychosomatic disorders, addictive disorders, and post-traumatic stress disorder. The chief manifestations are difficulty in describing or recognising one's own emotions, a limited fantasy life, and general constriction in the affective life.

J. C. Nemiah, R. J. Campbell (ed.), 1994.

A different entry appears in an earlier Psychiatric reference work, also edited by the psychoanalyst R. J. Campbell.

Psychiatric dictionary, 1989, p.28.

Alexithymia Difficulty in describing or recognizing one's emotions; suggested by P. Sifneos to describe those patients who define emotions only in terms of somatic sensations or of behavioral reactions rather than relating them to accompanying thoughts. "They … give the impression that they do not understand the meaning of the word 'feeling'." (Short-term Psychotherapy and Emotional Crisis, 1972). Their emotional functioning in general appears constricted and their phantasy life is limited and lackluster.

Some believe alexithymia reflects an absence of the ego functions that subserve affect and phantasy, but most writers explain it as due to primitive ego defenses that hide and distort the conscious experience of affect and phantasy.

R. J. Campbell, 1989.

By contrast, the following definition is written specifically with the neuropsychological audience in mind:

The Blackwell Dictionary of Neuropsychology, 1996.

alexithymia A disruption of both affective and cognitive processes, alexithymia is a collection of traits rather than a psychiatric syndrome. Alexithymics are incapable of expressing emotions in the sense that, while the emotion may be experienced, the emotion cannot be associated with a mental representation and so formally expressed. Alexithymia has classically been described in patients with psychosomatic disorders, but also in alcoholics, drug addicts, and patients with traumatic stress disorders.

Alexithymia has been reported in commisurotomy patients, and following right hemisphere stroke. These may be regarded as primary alexithymias, while secondary alexithymias may be associated more closely with psychogenic processes of denial and repression. It has also been suggested that alexithymia reflects a variation in cerebral organisation, and that this may be demonstrated by LEMs ; others have proposed that alexithymia results from a functional disconnection between the cerebral hemispheres.

The Blackwell Dictionary of Neuropsychology, p.43-4.

The secondary alexithymia mentioned in the entry above corresponds to Sifneos's version of the primary/secondary distinction, referring to neurogenic/psychogenic causes respectively; it does not correspond to the original distinction introduced by Freyberger, between alexithymia as a persistent trait (primary) and alexithymia as a transient state of suppressed emotionality in reaction to immediate psychological trauma (secondary). Krystal represents both versions in the definition below.

Psychoanalytic Terms and Concepts, 1990, p.11.

Alexithymia: A cognitive style and affective disturbance commonly found in patients suffering from psychosomatic, addictive, or post-traumatic conditions. The alexithymic state is characterized by poorly differentiated and poorly verbalized affects that do not serve the signal function adequately (do not communicate effectively). Psychosomatic patients, for instance, often ignore psychic and somatic danger signals, presenting a stoical appearance, sometimes with a stiff posture and wooden facies. Addictive patients particularly fear the somatic components of affects and try to block them, especially by chemical means. Post-traumatic patients are often unable to experience pleasure (a condition known as anhedonia).

Individuals suffering from alexithymia think in an operative way and may appear to be superadjusted to reality. In psychotherapy, however, a cognitive disturbance becomes apparent as the patients tends to recount trivial, chonologically ordered actions, reactions, and events of daily life with monotonous detail. In general, these individuals lack imagination, intuition, empathy, and drive-fulfillment fantasy, especially in relation to objects. Instead, they seem oriented toward things and even treat themselves as robots. These problems seriously limit their responsiveness to psychoanalytic psychotherapy; psychosomatic illness or substance abuse is frequently exacerbated should these individuals enter psychotherapy.

The term was introduced by Sifneos in 1967 and further clarified and elaborated by Nemiah and Sifneos in 1970. In the large body of literature that treats the concept, some authors attribute the manifestations to primary neuroanatomical deficits, while others point to various psychological problems, primary and secondary. McDougall and others see the phenomena from a psychoanalytic point of view as a group of developmental defenses closely allied with denial and splitting. A similar group of defenses, described in 1963 by Marty and his co-workers in France, was named la pensée opératoire.

Henry Krystal, 1990.

Online Definitions

The definitions to be found on internet dictionaries are admirably accurate, perhaps because they are simply trying to define the word without pushing a particular theory.

The Autism.org Glossary

Alexithymia: A disruption in both affective and cognitive processes. It is not treated as a 'true' psychiatric syndrome but rather as a general charactersation of a number of traits which are often seen together in a variety of disorders including those with psychosomatic origins and some addictions and drug-dependency disorders. Typically the alexithymic person has relatively undifferentiated emotions and thinking tends to dwell excessively on the mundane.

http://access.autistics.org/resources/glossary/main.html

Iverson Software Dictionary of Terms & Terminology of Psychology

Alexithymia - A disturbance in affective and cognitive function that overlaps diagnostic entities but is common is psychosomatic disorders, addictive disorders, and post traumatic stress disorder. The chief manifestations are difficulty in describing or recognizing one�s own emotions, a limited fantasy life, and general constriction in the affective life.

http://www.iversonsoftware.com/reference/psychology/a/alexithymia.htm

Concise Medical Dictionary

alexithymia n. a lack of psychological understanding of one's own emotions and moods. It is considered by some psychiatrists to be a way in which people develop psychosomatic symptoms.

http://www.xrefer.com/entry/121410

mentalhealthandillness.com

Alexithymia is an inability to recognize, experience and describe feelings. Anhedonia is an inability to recognize, experience and describe pleasurable feelings. There may be degrees of both alexithymia and anhedonia.

Since the capacity to feel emotions is a critical component of empathy, alexithymia can result in a decline in the capacity for empathy. A number of conditions can cause alexithymia including autism, Asperger's Syndrome, development failures, PTSD and injuries from encephalopathies.

http://www.mentalhealthandillness.com/neuralnetwork.html

Alleydog.com

Sifneos (1972) coined the term alexithymia to designate a group of cognitive and affective characteristics typical of many patients with psychosomatic illnesses. It is thought to be a personality trait that is characterized by a decreased ability to communicate feelings, a decreased ability to identify feelings, a cognitive tendency toward detail and external operations or events, and a paucity of imaginative thought, dream recall, or fantasy (Taylor, 1994).

http://www.alleydog.com/glossary/definition.cfm?term=Alexithymia __________________________________________________________________________________________________

What a gold-mine! Soulgany101 06:52, 7 August 2007 (UTC)

None of the above has a single thing to do with the notability of the two links, to self published, not peer reviewed, sites, run by the same person that you keep posting. Will you please stop trying to use Misplaced Pages to promote the personal websites of your aquaintances. --Zeraeph 07:47, 7 August 2007 (UTC)

Zeraeph. Lets just correct your rather characteristic attempts at innuendos before I start editing. Firstly, I am not trying to "promote" any person or website. I'm merely trying to provide good information for Misplaced Pages readers, and the information on those sites is second to none. Secondly, I am not a personal acquaintance of Sam Brown. I have never met him, and have had only impersonal exchanges with him on a discussion forum. I have not exchanged even impersonally with him for a long time. Soulgany101 08:01, 7 August 2007 (UTC)

Please read WP:RS and WP:EL on what constitutes "good information". I think you will find that self published work without peeer review does not hack it, nor should it. But even if it DID, two links to the same person's websites is unacceptable and could be considered linkSPAM. --Zeraeph 04:11, 8 August 2007 (UTC)

Admittedly one or two of the links are broken. So if you want to delete it on a technical point go ahead and do so. And thanks at least for discussing it (is good emotional ettiquette, even if you are right). Soulgany101 04:24, 8 August 2007 (UTC)

Comorbidity

We cannot use the word 'comorbidity', as that applies to co-existing diseases or disorders. Alexithymia is neither. CeilingCrash 20:36, 9 August 2007 (UTC)

Well spotted!! Of course we can't. --Zeraeph 23:42, 9 August 2007 (UTC)

Well, its hardly an important point, as comorbidity can be applied to the co-presence of two "conditions", and alexithymia can be (and often is) described as a condition, although it is simultaneously a 'trait'. In other words comorbidity need not apply to disorders only.

But I note that in line with your concern about this term, Greame Taylor (The world's leading authority on alexithymia) does not use the term comorbidity in his main book on alexithymia. So I've borrowed his phrase of 'Alexithymia in medical and psychiatric illness' from his book Disorders of Affect Regulation and used this as the subtitle in place of comorbidity. Soulgany101 07:49, 10 August 2007 (UTC)

PS. As an afterthought I suppose dropping 'comorbidity' ensures that people don't get the wrong idea that alexithymia is an extra disorder being tacked onto Asperger's. Thats a valid concern. Soulgany101 08:08, 10 August 2007 (UTC)

State vs' trait

CeilingCrash, I removed the following, unsourced paragraph by you: "Alexithymia is not a fixed personality trait, it has been shown to be state-dependent. Objections to its validity have been raised, in particular that it has been applied to clinical populations without correcting for the prevalence of depression in those populations. One study reported that, once this correcting was made, individuals classified as alexithymic by the TOR-20 scale were actually more emotionally expressive than the control - precisely the reverse intended purpose of the test."

You have made several errors here. Firstly your comment is totally unsourced. Secondly it is completely incorrect to state that alexithymia is not a fixed personality trait, when in fact most studies find that it is. There are rarer studies which claim that alexithymia can be "state dependent" and that it disappears after the evoking stressful situation has changed... but if you want to refer to these studies you need to cite them accurately and provide references. Thirdly, there is no such thing as a "TOR-20", I assume you meant the TAS-20??

I have nothing against providing a mention of studies finding examples state-dependent alexithymia, but it is a huge error to offer your unverifiable POV that alexithymia doesn't constitute a fixed personality trait. Soulgany101 10:36, 10 August 2007 (UTC)

Well as you know sources for the statement CC made, why didn't you just put the citations in instead of suppressing the paradigm presented altogether? That really IS conscious POV editing on your part, and not remotely acceptable. --Zeraeph 10:45, 10 August 2007 (UTC)

No, I don't know his sources at all. Soulgany101 11:37, 10 August 2007 (UTC)

Zeraeph. Your (following) passage needs to be clarified, as it is too vague and generalized- "Alexithymia is not necessarily a fixed personality trait, in some studies it has been shown to be state-dependent. Objections to its validity have been raised, in particular that it has been applied to clinical populations without correcting for the prevalence of depression in those populations"

You need to make clear exactly who applied the alexithymia concept improperly, to which clinical population/s, and in which studies, specifically. Otherwise you make it sound like general practice that the alexithymia concept is always applied incorrectly. If you cannot be specific then the sentence does not belong, and I will remove it as misleading (incomplete).

I don't have to make ANYTHING clear, I just found one citation for cc's statement. You claim to know of others and yet deleted it rather than put them in. --Zeraeph 14:01, 10 August 2007 (UTC)

It would also be more accurate to say that alexithymia is "not always" a fixed trait, instead of your present wording "not necessarily" which may also mislead readers into thinking that the "trait" idea may be in complete doub't. It isn't! The majority of studies confirm alexithymia as a stable trait. See Disorders of Affect Regulation for empirical proof. Soulgany101 11:51, 10 August 2007 (UTC)

"Not necessarily" is a better phrase, simpl because it could mean either way. "Not always" implies that it has been established beyond doubt that there are times when it is a fixed trait, and it has not.--Zeraeph 14:01, 10 August 2007 (UTC)

Ok. I've just read that article you cite, and can also see you are not quoting it faithfully. Where does it use the phrase "without correcting"?? Soulgany101 12:30, 10 August 2007 (UTC)

I didn't *quote* anything, I popped it in as a citation for the existing text, it doesn't need to be verbatum. In fact, too much verbatum is a BAD IDEA vis a vis copyright --Zeraeph 13:57, 10 August 2007 (UTC)

PS. As I said, I have no problem with the mention of alexithymia as state dependent, in fact I welcome it. I just dont want to see the wording deliberately or accidentally inferring that it must forever be one or the other across the entire range of disorders. It can be either, potentially. When it comes to clinical studies, the trait finding definitely appears more frequently, but the state finding also crops up as a valid finding sometimes. On a tangential issue, I wouldn't be surprised if Berthoz, Hill, or Frith have ascertained whether alexithymia in AS is state or trait. Although one might assume that the alexithymia in AS is enduring, it would be good to see the findings. Soulgany101 12:57, 10 August 2007 (UTC)

Well then, let's not state that "most studies" say one or the other, without actually finding 'em all and counting 'em...I was prepared to accept that "most studies" found it stable, until I did a REALLY NARROW search for a certain type "state dependent" and found SO MANY STUDIES. --Zeraeph 13:57, 10 August 2007 (UTC) And what do all those "so many studies" say, Zeraeph?? Soulgany101 14:43, 10 August 2007 (UTC)

Zeraeph. If you make out that there is an argument about state vs trait alexithymia, I will ask you to prove it, and if you can't I will delete it. Also, if you misquote studies as you did with the alexithymia-depression study, then I will correct or delete it. You wrote a sentence about an "objection" aired by the authors of that study, and when I read the study I saw nothing that strongly worded, and in fact the study was not concerned so much with whether or not other studies had screened for depression, but whether there had been adequate follow-up with the chosen patient group.

There is no real debate about whether alexithymia should be considered either a state or trait. Rather it depends on the individual and context. The experts are not arguing about this as much as you think. All that has to be said in a simple sentence is that there can be state or trait versions of alexithymia. simple. I could probably easily dig up references (which I have frequently come across) to the much more frequent finding of trait alexithymia, but at this stage I don't even consider it that important. There doesn't have to be a big conspiracy, nor a battle between state or trait, nor a battle between various researchers. Lets just keep it simple, clear, and referenced. Soulgany101 14:40, 10 August 2007 (UTC)

Stop distorting things, CC wrote those things, you deleted them, while claiming you knew of references for them. which was inexplicable behavior on your part, so I took 5 minutes to dig up a single reference to cover replacing half the statement.

HOWEVER, during those five minutes I found out that there MOST CERTAINLY IS a valid dabate (something I had never heard of until you wantonly deleted CC's text), and I am rather afraid that now I know that, I cannot, in all conscience, allow you to continue POV pushing to distort and suppress that in the article.

I sincerely wish that you would go away, have a little think quietly, and recognise that you might have a far better grasp of the world around you if you looked at it with a view to finding out what IS there rather than with a view to finding evidence to support your, often distorted, pre-formed ideas. As that is unlikely, I am hoping to get a couple of editors who are as impartial as fate, and VERY fond of verifiable facts, and NPOV, to keep an eye on your POV pushing antics that are a lot less subtle than you think they are. --Zeraeph 14:46, 10 August 2007 (UTC)

1. comorbidity

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